GOP Platform Silent on Medicare Change

by David Pittman David Pittman,Washington Correspondent, MedPage Today
August 28, 2012

TAMPA, Fla. -- While healthcare in general -- and Medicare in particular -- is playing a prominent role in the Republicans' presidential campaign strategy, the party's campaign platform appears to downplay the issue of transforming Medicare into a "premium-support system."

The finalized Republican platform, released Tuesday afternoon, makes no direct reference to a congressional plan to overhaul Medicare but does openly state it would like to turn Medicaid into a block-grant system.

In his Medicare reform plan, Republican vice presidential nominee Paul Ryan (R-Wis.) has proposed to offer those who turn 65 after 2022 an average of $8,000 to help offset the cost of buying private health insurance. Those eligible would be able to enroll in the traditional fee-for-service Medicare -- but would receive premium support for that option just as those using private plans would.

But that idea is barely mentioned in the Republican platform, which the party updates every 4 years around its convention, held this week in Tampa, Fla.

The platform makes oblique reference to Ryan's plan for Medicare, saying the party wants to remove the federal government from control of health coverage and to promote alternatives to fee-for-service models and government-sponsored health savings accounts.

The platform calls for promoting flexibility at the state level, while promoting a free-market system and consumer choice. Its reforms "will return direction of the nation's healthcare to the people and away from the federal government."

"We seek to increase healthcare choice and options, contain costs and reduce mandates, simplify the system for patients and providers, restore cuts made to Medicare, and equalize tax treatment of group and individual health insurance plans,"it states.

The Republicans also call for greater price transparency, hoping to hold down the over-utilization of care if patients know how much it costs.

Like Ryan's reform plan, the platform wants to transform Medicaid into a block-grant system. The Affordable Care Act's (ACA) Medicaid expansion could not function because it lacks other reforms, the platform states. Furthermore, it would place tremendous "unsustainable financial burdens" on states.

Not unexpectedly, the GOP calls for a total repeal of the ACA. The platform says a Republican president would on his first day in office halt the law's implementation before signing its repeal into law if a repeal were passed by Congress.

"Obamacare has been struck down in the court of public opinion and is falling by the weight of its own confusing, unworkable, budget-busting, and conflicting provisions," the platform reads.

But there are platform planks that are similar to President Obama's health overhaul: lowering healthcare costs by improving quality, increasing access to preventive services to lower the burden of chronic diseases, and covering preexisting conditions.

The platform also calls for expanded use non-embryonic stem-cell research and continued support of applied biomedical research. It also wants to restore the ban on drugs used in physician-assisted suicide.

The party also pledges to reform the FDA to keep the U.S. as the leader in medical technology, an advantage the Republicans say is at risk because of the FDA's lack of predictability, consistency, and transparency.

As in the past, tort reform remains an issue. The platform says the threat of malpractice lawsuits are causing physicians to practice in a defensive manner and turn away complex and high-risk medical patients.